Diabetes Prevention and Management by lay health workers in Nepal

Harilal Tiwari of Lekhnath-32 is a 58 years old male. He hasbeen a smoker and consuming alcohol for a long time. Ignoring the suggestions from his family and health workers, neither  did he  quit smoking nor  drinking harmful amount of alcohol.

Debka Tiwari, a female community health volunteer(FCHV), said when measuring this person’s  blood pressure, it was found high and she  advised him to go to the hospital immediately for a quick management and treatment. But due to the fear of being prescribed for a  medicine, he did not go to any health facility for the treatment of high blood pressure.  Unfortunately, he died within a matter of a few days due to cardio-vascular disease. 

“We have lost a lot of lives due to neglected non-communicable diseases,” said Tiwari, a female community health volunteer.

लेखनाथ ३२ का हरिलाल तिवारि ५८ बर्षको हुनुहुन्थ्यो । उँहाले लामो समयदेखि धुम्र्रपान र मादक पदार्थ सेवन गर्नुहुन्थ्यो । परिवार र अन्य स्वास्थ्यकर्मि हरmको सुझाब लाई बेवास्ता गर्दैं मादक पदार्थ सेवनमा कत्ति कम गर्नुभएन ।
बारम्बार स्वास्थ्य स्वयंसेविका देबका तिवारीले रक्तचाप मापन गर्दा बडी देखिएको र तत्काल अस्पताल जान सल्लाह दिनुहन्थ्यो । तर औषधी सेवन गर्नुपर्ने डरले जँचाउन जानुभएन । एकाएक ज्यानै जाने अवस्थासम्म आइपुग्नुभयो र त्यसको केही दिनमा उच्च रक्तचापको कारणले उँहाको ज्यान गयो ।
स्वयंसेविका तिवारीले हामीले वास्ता नगरेकै रोगले गर्दा कँयौ को ज्यान जाने गरेको बताउनुहुन्छ ।

A 93-year-old cancer patient, Mr. Bhimlal Shrestha was looking for someone to help him to get his regular medicine. He had to take a medicine named Calutide 50 every day. According to the health coordinator of Rupa rural municipality, on 31st May Shrestha reported that his medicine will be finished in next few days. After the implementation of Helmet Doctor project in Rupa rural municipality, the son of Shrestha informed us about the problem they are facing due to lockdown.  Our staff of the Helmet Doctor project went to various pharmacies in search of the medicine but the medicine was already out of stock in the town. We came to know that the medicine is available in one of the medical shop in Chitwan district situated 125 km south-east of Pokhara. Due to lockdown, it was impossible for us to go over there. The patient shared that he had severe bleeding from penis due to lack of the same medicine  in the beginning of March 2020. At that time, he was not able to take medicine for 5 days. This made us more emotional and pushed us to help him as soon as possible. After finding the exact address of the medical shop in Chitwan, and with the coordination with one of the staff of Nepal Development Society (NeDS) in Chitwan, they facilitated  sending the medicine from Chitwan to Pokhara.  We were able to receive medicine at 8:00 pm on 5th June 2020. Then the next day which was a Saturday, we reached   the patient at his door-step to handover 100 tablets of the medicine to his son. Had it been one-day delay, the patient would have to miss his regular dose. The son thanked us and our team for the rapid response.